Population Council Research that makes a difference

In the developing world, a woman dies every eighth minute because of complications arising from unsafe abortion and miscarriage. In Kenya, such maternal health complications were the fourth leading cause of morbidity among women in 2006. Rift Valley Province, where this study takes place, has consistently had the highest number of cases of abortion-related outpatient morbidity in the country since at least 2003.

In 2005–07, the first phase of the Community Post-Abortion Care (COMMPAC) project was implemented in Nakuru, Rift Valley Province, Kenya, by EngenderHealth under the USAID-funded ACQUIRE project. COMMPAC aimed to increase access to postabortion care (PAC) services by enhancing knowledge of sources of care and reducing fear of stigma, dissatisfaction with provider attitudes and performance, the cost of services, transportation difficulties, misperceptions among communities regarding PAC, and the perceived severity of complications. During this intervention community mobilization had a significant effect on the local environment and on health service delivery.

Following the successful implementation of COMMPAC, the Population Council replicated the COMMPAC model in a new site in Rift Valley Province and undertook a rigorous evaluation to systematically determine and document the most effective strategies to engage communities in PAC and to measure the effects of these strategies.

The evaluation has multiple purposes. It will provide documentation of the knowledge gained by the community on complications related to unsafe abortion and miscarriage and unplanned pregnancy, the acceptability of PAC services to clients and communities; the ability for the model to be scaled up within the resources and frameworks available from Kenya's Ministry of Health; and the potential for the COMMPAC model to improve health care utilization and thus contribute to improved health outcomes.

The Population Council is managing the research process, data management, and dissemination of the findings. It is responsible for developing the research protocol and tools, obtaining ethical clearance, managing the subcontracted agency that will do fieldwork and collect and analyze data, and disseminating the findings. A subagreement will be awarded to the Council by EngenderHealth for the collection of data; the Council is responsible for identifying and choosing an appropriate data collection agency.

The first phase of the project took place from August 2009 to June 2010.   A second phase has now begun, to be finished in June 2011.